Macon wins support for dialysis center in state appeal

Getting a kidney dialysis center in Franklin grew more likely last week after a state committee agreed Macon County had demonstrated a tangible need for such a facility.

With a county population older than that of many surrounding communities, an increasing number of residents here have been forced to travel over Cowee Mountain to Sylva for treatment.

Driving to Sylva is an inconvenience during the warm-weather months, but during snowfall, it is a true danger for those seeking the lifesaving medical procedure, dialysis family members and patients have said. Last winter’s harsh weather set the stage for Macon County’s dialysis-center push, highlighting the difficulties patients faced making their way to the nearest facility in Sylva.

Macon County has a loose agreement from DaVita, a publicly traded national company that operates the dialysis center in Sylva, to come into Franklin if the state gives the OK. The state limits health care competition to ensure hospitals and medical facilities are financially viable, issuing a “certificate of need” only if patient demand warrants it. In this case, the state said there wasn’t enough demand for a dialysis center in Macon County.

Macon County leaders objected to the state’s assessment, however. DaVita prepared a letter of support for the county to show state officials, signaling its intentions to consider opening a center in Franklin.

The state requires that new dialysis facilities be able to project a need for at least 10 dialysis stations, or 32 patients — at last official count, in the state’s semiannual Dialysis Report, Macon County had just 23 residents receiving dialysis.

But county officials dispute that number, saying that more than 30 dialysis patients currently drive U.S. 441 from Macon County to Sylva for treatment. Additionally, officials suspect there are some dialysis patients in the southern end of the county driving to neighboring Clayton, Ga., who aren’t included in that number. The state’s threshold for justifying a kidney dialysis center also doesn’t take into account the particularly arduous health challenges associated with end-stage renal disease — yet Macon County’s end-stage population is increasing by an average of 10 percent a year, according to county records.

The state uses a 30-mile radius to determine locations of dialysis centers.

Friday, the long-term and behavioral care committee, meeting in Raleigh, agreed unanimously with Macon County’s arguments, according to County Manager Jack Horton. The committee recommended Macon County be allowed to build a five-bed dialysis center; that bed number could change to accommodate increased need.

The proposal now hangs on a State Health Coordinating Council meeting set for Sept. 28, said Macon County Commissioner Ronnie Beale, who has led the dialysis-center push.

Beale was optimistic the 29-member council would approve the proposal. If that happens, in March the county would apply for a certificate of need, which Beale believed would be forthcoming.